NCCA-accredited Certified Personal Trainer (CPT) Exams: Meta-analysis of Topics (Domains)

by Brent Brookbush, DPT, PT, MS, CPT, HMS, IMT,

and David Boettcher, MS, BS, CPT, HMS

This meta-analysis was performed during the application process for developing an NCCA-accredited Certified Personal Trainer (CPT) Certification Exam

This certification exam is a distinct offering from our Certified Personal Trainer (CPT) education program and the certificate awarded following the completion of those Brookbush Institute courses.

Introduction

The role of personal trainers in guiding individuals toward their fitness goals demands a nuanced understanding of essential domains (topics), including functional anatomy, exercise selection, exercise progression, program design, and acute variables. Further, additional competencies have been suggested, including nutrition, professional ethics, corrective exercise, psychological insights, etc. Despite the proliferation of personal training certifications (CPT) accredited by the National Commission for Certifying Agencies (NCCA), no one has attempted to determine industry standards by systematically comparing NCCA-accredited certifications, until now.

This study includes a systematic review and meta-analysis of 8 NCCA-accredited certified personal trainer (CPT) exams to evaluate their domain weighting and identify congruence across organizations. The review seeks to establish an industry-wide standardized blueprint, addressing a significant gap in certification uniformity. By synthesizing job analyses, blueprints, and exam content, this review not only highlights the essential tasks of personal trainers, but it also highlights organizations with exams that significantly deviate from the industry standards based on averages.

Note that this publication also asserts ideas about the potential for bias in isolated exam development and proposes a collaborative path forward for the fitness industry. It underscores the importance of aligning certification processes with evidence-based practices to elevate professional standards, reduce variability, and ultimately enhance client outcomes.

Results Summary:

Average Percentage (and Standard Deviation) for Each Domain for All NCCA-accredited Exams

Domains: Topics
• Domain 1: Functional Anatomy and Muscle Physiology (32%)
• Domain 2: Exercise Selection, Assessment, Cueing, Progression, and Regression (30%)
• Domain 3: Acute Variables, Program Design, Training Goals, and Adaptations (28%)
• Domain 4: Additional Topics (10%)

Caption: Average Percent Weighting for Each Domain: Domain 1: Functional Anatomy and Muscle Physiology (32%); Domain 2: Exercise Selection, Assessment, Cueing, Progression, and Regression (30%); Domain 3: Acute Variables, Program Design, Training Goals, and Adaptations (28%); Domain 4: Additional Topics (10%)

Comparison of Average Domain Weighting to Actual Domain Weighting for Each Organization

Caption: Comparison of Average Domain Weighting to Actual Domain Weighting for Each Organization: NASM, ACE, ACSM, NSCA, NFPT, ISSA (NCCPT), NESTA, and NCSF

Systematic Review

Personal Training Essential Job Tasks

• Personal trainers are fitness professionals responsible for designing and implementing
  personalized exercise programs to aid individuals in achieving their fitness goals. Personal trainers
  work closely with clients to assess their fitness levels, set realistic goals, and provide guidance and
  motivation throughout the fitness training experience.
• Most of the trainer/client interaction is spent instructing the client while “working out,” including selecting exercises, teaching exercises, cuing form for ideal exercise performance, progressing and regressing exercises, adjusting acute variables (reps, load, sets/exercise, etc.) to optimize adaptations (with a lower risk of injury), and discussing longer-term program design to ensure optimal outcomes.
• Additionally, the selection of client-appropriate exercise and acute variables, cuing optimal
  form, and progressively and appropriately increasing exercise intensity may significantly reduce the
  risk of musculoskeletal injury during the fitness training experience.
  • Validation of Essential Job Tasks: The subject matter experts at the Brookbush Institute and the external review board agree with the statements above, and the external review board added that many certifications do not adequately prioritize the practical component of a personal trainer's job; that is, "instructing the client while working out."

Why a Meta-analysis of Domains?

It is assumed that published documents for 8 previously published NCCA-accredited job analyses, blueprints, and CPT exams are sufficient information to develop a standardized exam blueprint via a systematic review. This systematic review would include developing common domains, sub-domains, and sub-topics and the percentage of exam questions that focus on each domain and sub-domain. It is assumed that a systematic review would result in a relatively fair and unbiased blueprint for future exams in the industry (and/or the eventual development of a single credentialing exam).

Further, the Brookbush Institute asserts that yet another job analysis panel and job task survey is more likely to result in biased information than a systematic review (SR). The potential for a job analysis survey to result in significant deviations from established averages would seem fairly large without a review of previously published blueprints. We believe this article is the first review to be available to the public. Further, the job task analysis survey is likely to introduce bias unless a questionnaire is validated by several groups (e.g., starting with hypothesis generation errors, influence from provider preferences, sampling bias, etc.), and no such questionnaire exists.

This systematic review also investigated the congruence between previously published NCCA-accredited exam blueprints. Congruence was defined as dedicating the same percentage of test questions to a domain within 1 standard deviation (SD) of the average percentage given to that domain by all organizations. It is our assertion that a lack of congruence likely implies some level of bias in the test blueprint creation process. This is not to imply that bias is inherently bad but implies that some organizations are not representative of the majority of education providers. These organizations have likely defined the scope of personal training differently than the industry average, or their exam includes company-specific content (e.g., ACSM testing on risk stratification, NASM testing on the OPT model, ACE testing on the IFT model, etc.). A lack of congruence was defined as a domain weighting beyond 1 standard deviation from the average.

Exam Development Issues

It should be noted that it is not the explicit intent of an organization like NCCA to have every individual education provider in an industry create their own accredited exam. Organizations like the NCCA design processes with the intent to accredit a fair credentialing exam for a profession; for example, the licensing exam for physical therapists, nurses, elevator technicians, etc. Unfortunately, the fitness industry has likely developed the standard of individual NCCA-accredited exams for two inconvenient business reasons and not for reasons of "best practice." First, health club chains and other relatively large employers want easy-to-implement hiring practices such as "will accept certifications accredited by the NCCA." This, unfortunately, creates a barrier for any more appropriate 3rd-party review, accreditation, or approval from gaining traction. Unfortunately, this "HR Department Standard" is likely the byproduct of an industry that does not understand the accreditation process, does not understand that NCCA accreditation does not establish minimum standards for content accuracy or education delivery, and does not understand the administrative burden and additional cost to students. Further, individual certification providers, either due to an assertion that their "domain expertise is unique" or potentially in an act of collusion by the large providers to prevent competition from new companies, have vigorously fought against the development of a single exam. Perhaps this systematic review will give companies a path forward for "averaging" domain knowledge, and companies like the Brookbush Institute developing an NCCA-accredited exam and then fighting for a different solution will change accepted industry norms.

Providers

This systematic review (SR) started with a search and review of all previously published job analyses and exam content documents that could be located on the Internet. Materials for 8 previously approved NCCA-accredited CPT exam providers were located. All documents were reviewed, and one document was selected from each provider that covered the information most relevant to this SR. Those documents are linked and cited below.

• National Academy of Sports Medicine (NASM)
• American Council of Exercise (ACE)
• International Sports Science Association (ISSA)
• American College of Sports Medicine (ACSM)
• National Strength and Conditioning Association (NSCA)
• National Federation of Personal Trainers (NFPT)
• National Exercise and Sports Trainers Association (NESTA)
• National Council on Strength and Fitness (NCSF)

Labeling and Sorting:

The goal of this step was to create a uniform list of sub-domains (sub-categories) and a model of domains (categories) that best fit the sub-domains of all organizations.

The first step in performing the systematic review below was to determine the synonyms used for sub-domain content and to choose a label for each group of synonyms. That is, various certifications will use synonyms for the same content, and that content must be matched and sorted to align with all other certifications. Further, some certifications used the same words to refer to different content, and those sub-domains had to be identified and organized with the appropriate sub-domains. The end product of this process was a list of all sub-domains labeled with the most common verbiage for that sub-domain.

After the list of sub-domains was created, the next step was to sort the sub-domains into a group of categories (domains) that “best fit” all of the sub-domains. Note that most certifications develop test blueprints from a list of domains and sub-domains. So, this was not a unique approach to organizing this content. The challenge was attempting to sort and label the data in such a way that was as unbiased as possible and accounted for the breadth of topics covered. Again, a variety of sorting issues had to be addressed.

• Sorting problem example: Some providers divided content by training goals (e.g., weight loss, hypertrophy, strength, etc.) and then discussed the ideal acute variable ranges for each (e.g., reps, load, sets, etc.). Other organizations divided content by acute variables and then discussed optimal ranges for acute variables based on training goals. The same content is being covered; however, it is sorted differently. This is the equivalent of reversing rows and columns in a table, and it should not have had a significant effect on outcomes (congruence as defined above).

We understand that several domain divisions may fit the sub-domains of all providers; in fact, it took several attempts to create the domains listed below. However, we did have some guiding principles that we believe were indicative of a "best-fit model."

• No domain would be created that only included sub-domains from a minority (less than 5) of providers.
• The domains chosen should result in the least amount of sub-domains falling into the "additional information domain (miscellaneous)."
• The domains chosen should result in the most congruence possible between providers.
• Domains should be developed in a way that most providers would perceive as “fair.” Although this is a relatively vague and subjective guideline, the intent was to reduce bias. Domains were developed with the goal that these choices would make sense to any experienced education provider, and any education provider with the same data would likely develop similar domains.

Unfortunately, without active participation from all providers, this may have been the most subjective portion of this SR. However, assuming that synonyms and like information were carefully matched, the authors doubt that this sorting and labeling issue would have resulted in a significantly different outcome if performed by other education companies. That is, although the organization of information by a different education company may result in different labels for sub-domains and the selection of different domain categories, this would not likely affect average domain weighting and the congruence between organizations. We hope that in the future, NCCA-accredited exam providers will work together to develop a better systematic review and standardized test blueprints.

Topic Domains

Once the 3 primary domains were developed, 1 domain for “Additional Topics” was added to ensure that the analysis for congruence was based on 100% of each provider's content.

The following section lists each domain, the synonyms applying to each domain, each provider’s topics in that domain category, and their percentages relative to the provider’s total content. In some cases, percentages are estimates based on the total number of items listed under a similar domain on the cited documents and/or estimates based on dividing subtopics listed in 2 domains into equal parts. The Brookbush Institute percentages were then listed, along with a detailed breakdown of our content. This detailed breakdown was used to develop a rough draft blueprint and accompanying study materials. The blueprint developed during this meta-analysis was reviewed at the end of the Job Task Analysis Panel Blueprint Development (part of the NCCA-accredited exam development process) with the goal of discussing the benefits and issues with creating an exam that is congruent with "industry average weightings."

Note that the goal of this SR was to determine the industry mean percentages for the Brookbush Institute to develop an exam that was congruent with current industry averages. For this reason, the Brookbush Institute’s percentage split of information was not used in determining the mean percentages of each domain. With the development of this SR, adjustments were made to ensure that the Brookbush Institute’s percentage of each domain, sub-domain, and sub-topics were congruent with the mean percentages of other providers. (With some small adjustments made to address the staff and review boards' concerns regarding prioritizing the practical components of a personal trainer's job).

Topic Domains
• Domain 1: Functional Anatomy and Muscle Physiology (32%)
• Domain 2: Exercise Selection, Assessment, Cueing, Progression, and Regression (30%)
• Domain 3: Acute Variables, Program Design, Training Goals, and Adaptations (28%)
• Domain 4: Additional Topics (10%)

Domains, Synonyms, and Content Breakdowns

Domain 1: Functional Anatomy and Muscle Physiology

Sub-domain: Functional Anatomy

• Synonyms: Kinesiology, biomechanics, exercise analysis, exercises assessment, exercise sciences, foundational science

Percent of the exam (weighting) allocated to the domain on NCCA-accredited CPT exams:

• NFPT: Principles of Human Anatomy 20%, Principles of Physiology 19%
• NESTA: Exercise Sciences 15%
• NCSF: Functional Anatomy 12% and Exercise Physiology 15%
• NASM: K1 – K5 17%
• ACE: Domain 1: CLIENT ONBOARDING AND ASSESSMENTS 31%
• NSCA: None
• ACSM: Component E. 1. Knowledge of A-O 25%
• NCCPT: Domain 1: Applied Sciences, 25

Brookbush Institute Functional Anatomy Breakdown: This domain covers anatomical position, planes of motion, joint actions, types of muscle contractions, the joint actions resulting from concentric contractions of the major muscle groups, and the analysis of exercise based on the plane of motions, joint actions, and contributing muscles.

1. Anatomical Position & Anatomical Directions
2. Planes of Motion
3. Joint Actions
4. Synovial Joints
5. Human Movement Systems (Joints, Muscles, Connective Tissue, and Nervous System)
6. Joints of the shoulder girdle and scapular motion
7. Scapular muscles
8. Deltoids
9. Rotator cuff
   1. First exercise analysis: reverse fly
10. Pectoralis major, latissimus dorsi, and teres major
    1. Listing internal versus external shoulder rotators and comparing the joint actions of the pectoralis major and latissimus dorsi
11. Biceps brachii, brachialis, triceps brachii, and coracobrachialis
    1. Analyzing the overhead press and close grip row, and new activity - “determine the function of a muscle.”
12. Hip flexors and anterior thigh
13. Gluteus maximus and gluteus medius
14. Hamstrings and adductors
    1. Listing the flexors and extensors, internal and external rotators, and activity - “determine the function of a muscle.”
15. Ankle joint actions and muscles
    1. Listing plantar flexors and dorsiflexors, and analyzing the squat
16. The spine and trunk muscles
17. Trunk Muscles Graph, Additional Core Muscles, and Core Exercise Challenge
    1. Listing the trunk actions and muscles, listing the muscles of the lumbopelvic hip complex, and the “core exercise (without hip flexion)” challenge

Sub-domain: Muscle Physiology

• Synonyms: Applied science, functional anatomy, human physiology, exercise physiology)

Percent of the exam (weighting) allocated to the domain on NCCA-accredited CPT exams:

• NFPT: Principles of Human Physiology 19%
• NESTA: Exercise Sciences 15%
• NCSF: Functional Anatomy 12%
• NASM: K1, K2, K4, K5 17%
• ACE: None
• NSCA: Program Planning C 23%
• ACSM: None
• NCCPT: Domain 1: Applied Sciences, 25%

Brookbush Institute Exercise Physiology Breakdown: This domain covers muscle cell structure and function, muscle fiber types, action potentials, motor unit recruitment, adaptation of muscle cells, etc.

1. Muscle cell structure and function
   1. Structure of muscle cells, muscle tissue traits, motor unit recruitment, sliding filament theory, and connective tissue
2. Muscle fiber types
   1. Type I and II muscle fibers, properties of Type I and II fibers, genetics, adaptations, and energy systems of muscle fibers.

Domain 2: Exercise Selection, Assessment, Cueing, Progressions, and Regressions

• Synonyms: Training development, programming, exercise instruction, evaluation, screening, exercise modification, exercise techniques, form modification.

Percent of the exam (weighting) allocated to the domain on NCCA-accredited CPT exams:

• NFPT: Training Program Development, Implementation, and Modification 33%
• NESTA: Exercise Applications and Instruction 9.8% and Assessment and Injury Prevention 18%
• NCSF: Screening and Evaluation 12% and Training Instruction 14%
• NASM: K23, K26, K34, K35, K37, K40, K42, K46, K54 – K60 40%
• ACE: Domain 1: Client Onboarding and Assessment (Task 3 of 4); Domain 2: Program Desing and Implementation (Tasks 2, 3, & 4); Domain 3: Program Modification and Progression (Task 3) 23%
• NSCA: Techniques of Exercise 31%
• ACSM: Domain I: Component F. 1. Knowledge of A-C; Domain II: Component B. 1. Knowledge of A; Domain II: Component F: Knowledge of A, D, & E. 21%
• NCCPT: Domain IV: Program Design and Implementation; Domain V: Exercise Selection, Technique, and Training Instruction (Only A) 30%

Brookbush Institute Strength and Core Progressions: This domain covers exercise selection, the kinesiology of each exercise, subsystems recruited during each exercise, relative flexibility progressions, exercise progressions, exercise regressions, form assessment and cuing, and relevant research.

1. Chest progressions
2. Back progressions
3. Shoulder progressions
4. Leg progressions
5. Deadlift progressions
6. Total body exercise progressions
7. Lower body power exercises
8. Upper body power exercises
9. Bridge progressions
10. Plank progressions
11. Transverse abdominis progressions

All items include:

1. Kinesiology of movement patterns
2. Recruited myofascial subsystems
3. Relevant research
4. Exercise performance, assessment, and cueing
5. Progressions and regressions
6. Sample programs

Domain 3: Acute Variables, Program Design, Training Goals, and Adaptations

Subdomain: Acute Variables and Program Design

• Synonyms: Exercise prescription, principles of resistance training, fitness training components, training methodologies, resistance training methods, and exercise criteria

Percent of the exam (weighting) allocated to the domain on NCCA-accredited CPT exams:

• NFPT: Fitness Components 23%
• NESTA: Program Design 16%
• NCSF: Exercise Programming 29%
• NASM: K2, K44 – 46, K48, K50, K53 21%
• ACE: Domain 2: Program Desing and Implementation (Task 2 ~ 1/4 of 31%); Domain 3: Program Modification and Progression (Tasks 1, 2, & 3) 27%
• NSCA: Program Planning 32%
• ACSM: Domain II: Component B. 1. Knowledge of A, B, E, F; Domain II: Component F: Knowledge of A, C 20%
• NCCPT: Domain IV: Program Design and Implementation 25%

Brookbush Institute Acute Variable Breakdown: This domain covers the relationship between the acute variable recommendations, program design, adaptations, and training goals.

1. Training frequency
2. Load
3. Rest between sets
4. Sets per muscle group

All items include:

1. Acute variables for endurance, strength, power, hypertrophy, body composition (weight loss)
2. Effect on hormones, blood chemistry, cardiovascular health, and performance, and markers of general health (e.g., osteoporosis, sarcopenia, etc., when research is available.)
3. Electromyography research
4. Effect on older populations, adults, and younger populations (less than 18 years of age)
5. Effects on novice and experienced exercisers (and college and professional athletes)
6. Sample programs

Sub-domain: Training Goals and Adaptations

• Synonyms: Power training, training for explosiveness, speed/agility/quickness training, reactive training, speed training.

Percent of the exam (weighting) allocated to the domain on NCCA-accredited CPT exams:

• NFPT: None
• NESTA: None
• NCSF: None
• NASM: K35, K40, K41, K53, K55, K60 21%
• ACE: Domain 2: Program Desing and Implementation (Task 2 of 4) 31%; Domain 3: Program Modification and Progression (Tasks 3 of 4) 27%
• NSCA: Client Consultation and Assessment 22%
• ACSM: Domain II: Component A. 1. Knowledge of D & E; Component B: 1. Knowledge of F, G 20%
• NCCPT: None

Brookbush Institute Training Goals: This domain covers the body’s adaptation to power training and power-related concepts.

1. Concepts, physiology, and principles of power (high-velocity training)
   1. Neural adaptations
   2. Muscle fiber adaptations
   3. Hormone response
   4. Training modalities
   5. Strength vs. Power
   6. Power program design

Domain 4: Additional Topics

Brookbush Institute Additional Topics: This covers additional topics that do not fit previously listed domains; however, may be relevant to the job of personal training.

1. Concepts, physiology, training modalities, and principles of stability training
   1. Lower body stability training
   2. Upper body stability training
   3. Core training
   4. Unstable surfaces vs. unstable loads
2. The effect of exercise on:
   1. Blood chemistry (hormones, lipids, growth factors, etc.)
   2. Cardiorespiratory changes (cardiovascular performance, markers of general cardiovascular health, cardiovascular disease, etc.)
   3. Osteoporosis/Bone mineral density
3. Scope of practice

Percent of the exam (weighting) allocated to the domain on NCCA-accredited CPT exams:

• Also notated is the varying additional content in the CPT exams across certifying bodies.
  • NFPT: Maintaining scope of practice 5%
  • NESTA: Nutrition, exercise psychology, and business application 41.2%
  • NCSF: Nutrition and professionalism & risk management 10%
  • NASM: Domain 1: Basic and Applied Science and Nutritional Concepts (k2 d, e, g; k6 – k16); Domain 5: Client Relations and Behavior (k62 – 68); Domain 6: Professional Development and Responsibility (k69 – 78). 22%
  • ACE: Domain IV: Risk Management, Professional Conduct, and Ethical Business Practices Task 1 (scope of practice and confidentiality), Task 2 (Code of Ethics), & Task 3 (business and marketing). 19%
  • NSCA: Program Planning C: Training adaptations, 2b – d (cardiovascular, metabolic, and endocrine); D: Training adaptations, 1 (special populations); Safety, Emergency Procedures, and Legal Issues 14%
  • ACSM: Domain 1: Component C Knowledge of 1 (cardiovascular disease) and 2 (PAR-Q); D Knowledge of 1 (SMART Goals); F Knowledge of 1 c (response of endocrine and cardiorespiratory system); Domain III: Leadership and Client Education; Domain IV: Legal and Professional Responsibilities 34%
  • NCCPT: Domain II: Nutrition; Domain VI: Professional Practice and Responsibility 20%

Results: Averages and Congruence

This systematic review (SR) compares the percentage of content each organization has given to each domain to the average percentage of all organizations for each domain. Congruence was defined as dedicating the same percentage of test questions to a domain within 1 standard deviation (SD) of the average percentage given to that domain by all organizations.

Domain 1: Functional Anatomy and Exercise Physiology: The mean percentage of total content for all providers was 26%, with a standard deviation of 7.3%. The most extreme differences were NESTA, with an actual difference of 11% less content, and NASM, with an actual difference of 9% less content, both exceeding 1 standard deviation.

• The Brookbush Institute’s proposed percentage for this content was 32%, with an actual difference from the mean of 6.0%, falling within one standard deviation.

Domain 2: Exercise Selection, Assessment, Cueing, Progression, and Regression: The mean percentage of total content for all providers was 30%, with a standard deviation of 5.5%. The most extreme differences for Domain 2 were ACSM, with an actual difference of 9% less content, and NASM, with an actual difference of 10% more content, both exceeding 1 standard deviation and contributing to significant variation.

• The Brookbush Institute’s proposed percentage for this content was 30%, with an actual difference of 0%, falling within one standard deviation.

Domain 3: Acute Variables, Program Design, and Training Goals: The mean percentage of content for all providers was 25%, with a standard deviation of 4.8%. The most extreme differences for Domain 3 were NESTA, with 8% more content, and NSCA, with 8% less content, both exceeding 1 standard deviation and contributing to significant variation.

• The Brookbush Institute proposed percentage for this content was 28%, with an actual difference of 3%, again falling within 1 standard deviation.

Domain 4: Additional Topics: It was noted that among all providers, there was significant variability in the topics covered. A minority of certifications covered topics such as stability/balance training, nutrition, business coaching, special populations, marketing, calculating target heart rate, psychology, legal issues, scope of practice, etc. Because these topics were represented by half or fewer of all providers, they were included in additional topics

The mean percentage of content for all providers was 21%, with a standard deviation of 11.2%. The most extreme differences for Domain 3 were ACSM, with 13% more additional content, and NESTA, with 20.2% more additional content, both exceeding 1 standard deviation.

• The Brookbush Institute proposed percentage for this content was 10%, with an actual difference of 11%, again falling within 1 standard deviation.

In summary, this SR demonstrates that several certifications are not congruent with the majority of the industry. Specifically, NESTA exhibited significant deviations from the mean for 3 domains, NASM and ACSM exhibited significant deviations for 2 domains, and NSCA exhibited significant deviations for 1 domain. The table below summarizes this information.

• This Brookbush Institute’s proposed weighting should be in alignment with "industry averages." However, the actual weighting of the exam will be matched to the new Job Task Analysis Panel, Job Task Survey, and Board Review that is required for the NCCA-accredited exam application process.

Comparison of Domain Percentages to other NCCA-approved CPT exams

Documents Used for Data-collection from NCCA-Accredited Exams:

• NFPT: https://nfpt.com/wp-content/uploads/Job_Analysis_summary2016.pdf
• NESTA: https://pft.nestacertified.com/wp-content/uploads/2013/09/NESTA-CMG-JTA-Report.pdf
• NCSF: https://www.ncsf.org/pdf/NCSF_2021_Annual_Exam_Report.pdf
• NASM: https://www.nasm.org/docs/default-source/PDF/nasm-cpt-executive-summary-job-task-analysis.pdf?sfvrsn=2
• ACE: https://acewebcontent.azureedge.net/assets/certification/pdfs/CPT-Exam-Content-Outline.pdf
• NSCA: https://www.nsca.com/contentassets/53ec33293e1c4551be4153186d4b2052/nsca-cpt-explanation-letter.pdf
• ACSM: https://www.acsm.org/docs/default-source/certification-documents/cpt/acsm-certified-personal-trainer-exam-content-outline-2022.pdf
• ISAA: https://assets.ctfassets.net/qw8ps43tg2ux/7KxejJj5WXgNhleXZrzZo4/c789e3aa043335ceb9641ad2d2accf81/nccpt-candidate-handbook.pdf

© 2025 Brent Brookbush (B2C Fitness, LLC d.b.a. Brookbush Institute)

Comments, critiques, and questions are welcome!